<!DOCTYPE html>
<html lang="zh-cn">
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no" />
    <meta name="renderer" content="webkit">
    <title>用户录入后台</title>  
    <link rel="stylesheet" href="/css/pintuer.css">
    <link rel="stylesheet" href="/css/admin.css">
    <script src="/js/jquery.js"></script>
    <script src="/js/pintuer.js"></script>  
</head>
<body class="bg">
<div >
    <div class="container">
        <div class="line bouncein">
            <div class="xs6 xm4 xs3-move xm4-move">
                <div style="height:0px;"></div>
                <div class="media media-y margin-big-bottom">
                </div>
                <form action="{:url('login/checkYjsregister')}" method="post">
                    <div class="panel loginbox">
                        <div class="text-center margin-big padding-big-top"><h1>用户录入后台</h1></div>
                        <div class="panel-body" style="padding:5px; padding-bottom:5px; padding-top:5px;">
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="username" placeholder="手机号" data-validate="required:请填写手机号" />
                                    <span class="icon icon-user margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="beans" placeholder="联豆数量" data-validate="required:请填写联豆数量" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="verify" placeholder="校验码" data-validate="required:请填写校验码" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <p>请认真核验银行卡号，仅可输入一次</p>
                                <div class="field field-icon-right">

                                    <input type="text" class="input input-big" name="bank_num" placeholder="银行卡号" data-validate="required:请填写银行卡号" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="user_name" placeholder="真实姓名" data-validate="required:请填写真实姓名" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="bank_name" placeholder="开户行" data-validate="required:请填写开户行" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="bank_addr" placeholder="开户行地址" data-validate="required:请填写开户行地址" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="bank_staff" placeholder="银行卡类型" data-validate="required:请填写银行类型" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="bank_phone" placeholder="银行预留手机号" data-validate="required:请填写银行预留手机号" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>
                            </div>
                            <div class="form-group">
                                <p>请认真核验支付卡号，仅可输入一次</p>
                                <div class="field field-icon-right">
                                    <input type="text" class="input input-big" name="ali_num" placeholder="支付宝号" data-validate="required:请填写支付宝号" />
                                    <span class="icon icon-key margin-small"></span>
                                </div>

                            </div>
                            <!--<div class="form-group">
                                <div class="field">
                                    <input type="text" class="input input-big" name="verify" placeholder="填写右侧的验证码" data-validate="required:请填写右侧的验证码" />
                                   <img src="{:captcha_src()}" alt="" width="100" height="32" class="passcode" style="height:43px;cursor:pointer;" onclick="this.src=this.src+'?'">

                                </div>
                            </div> -->
                        </div>
                        <div style="padding:10px;"><input type="submit" class="button button-block bg-main text-big input-big" value="录入"></div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>


</body>
</html>
